Donor Information. The Act bars stations from renting contributor names, donor names, or other personally identifiable information (collectively, Personal Information) to or from or exchanging Personal Information with any Federal, State, or local candidate, political party, or political committee. In addition, Grantees are barred, unless required by law, from disclosing Personal Information of contributors or donors to any Nonaffiliated Third Party (these terms are defined in the General Provisions), unless Grantee meets the following Communications Act requirements: • clearly and conspicuously notifies contributors or donors that the station may release its Personal Information to Nonaffiliated Third Parties; • advises contributors or donors before any disclosure, that they have the right not to have their Personal Information disclosed; and • explains to the contributor or donor how to exercise that non-disclosure option (47 U.S.C. § 396(k)(12)). Does Grantee disclose the Personal Information of contributors or donors to any Nonaffiliated Third Party? If yes, how does Grantee provide notification to contributors or donors (such as posting on the station's website or advising the contributor or donor using written correspondence or email)?
Donor Information. SECTION A: for Individuals only DONOR 1 DONOR 2 SECTION B: for Organizations & Trusts only
Donor Information. The Foundation shall be under no obligation to provide donor 65 information, including contact information, to the District or any other third party and 66 such information shall be kept confidential by the Foundation as requested by donors or 67 as deemed appropriate under the circumstance by the Foundation. 68
Donor Information. Donor 1 ( NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Nickname Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Date of birth Business or organization name Position Send mailings to my: Home Office Business address City State Zip Preferred phone Preferred Email Donor 2 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Nickname Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Preferred phone Preferred Email Estate or Deferred Gift Agreement (page 2 of 4)
Donor Information. Donor 1 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* Donor 2 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* Estate or Deferred Gift Agreement Donor 3 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx) Home address City State Zip Send mailings to my: Home Office Date of birth Business address City State Zip Phone (preferred) Email (preferred) Ethnicity* Donor 4 (NOTE: all correspondence will be sent to Donor 1 unless otherwise specified) Full name (first, middle, last) Preferred name Preferred salutation (e.g. Xx. Xxxxx X. Smith or Xxx Xxxxx)) Home address City State Zip Send mailings to my: Home Office Date of birth Business or organization name Position Business address City State Zip Phone (preferred) Email (preferred) Ethnicity*
Donor Information. Fill out all that apply and indicate those that do not apply. Last Name Mailing Address First Name Maiden Name Phone Number Email Have you donated before? Yes No Are there any notes about your contact information? This personal information is being collected under the authority of section 33(c) of the FOIP Act and will be used for administration purposes and to enhance the research value of the donated records. All information collected by the City of Edmonton is protected by the provisions of the FOIP Act. You may direct your questions about the collection, use, or disclosure of your personal information by contacting the City of Edmonton Archives at (000) 000-0000. Please list all the creators of the material being donated. In instances of published material, the creator could be the one responsible for collecting it. Fill out all that apply. If you require more space please include it at the end. Creator Name: Include the full name, including middle name and maiden name if possible. Creator Contact Info: If possible, provide the Creator’s contact information Creator Type: Individual | Family | Corporate Entity Circle the one which best applies. Bio/Admin History Provide as much background information as possible. For individuals and families this can include dates and places of birth/death, education, occupations, etc. For corporate entities this can include mission, mandate, business area, and dates of founding, incorporation, and dissolution. Creator Name: Include the full name, including middle name and maiden name if possible. Creator Contact Info: If possible, provide the Creator’s contact information Creator Type: Individual | Family | Corporate Entity Circle the one which best applies. Bio/Admin History Provide as much background information as possible. For individuals and families this can include dates and places of birth/death, education, occupations, etc. For corporate entities this can include mission, mandate, business area, and dates of founding, incorporation, and dissolution.
Donor Information. Primary Donor
Donor Information. Yes No Question Does Grantee disclose the Personal Information of contributors or donors to any Nonaffiliated Third Party? If yes, how does the Grantee provide notification to contributors or donors (such as posting on the station's website or advising the contributor or donor using written correspondence or email)?
Donor Information. Check here if the Donor is the same as the RI listed in Section 3 and continue to Section 6. Name (First, Middle Initial, Last) Social Security Number Date of Birth (MM/DD/YYYY) Street Address City State Zip Code Primary Phone Number
Donor Information. (For multiple donors, please include names of all donors that you would like to have recognized.)
